Hemochromatosis — or iron overload — is a condition in which your body absorbs and stores too much iron from the foods you eat.
This causes a build-up of iron, which can cause severe liver damage and other health problems.
Fortunately, in combination with medical treatment, diet plays an important role in managing hemochromatosis and preventing complications from the condition.
This article explains what to eat and avoid with hemochromatosis and provides a sample hemochromatosis diet menu.
What is hemochromatosis?
Hemochromatosis occurs when iron builds up in your body to harmful levels.
Hemochromatosis is similar to Wilson’s disease, except in Wilson’s disease, excess amounts of copper — rather than iron — accumulate in the body.
Iron is an essential mineral that your body needs for energy production, immune health, and to make proteins that supply oxygen to your tissues, among other functions.
Normally, your body tightly regulates iron absorption, but with hemochromatosis, your body continues to absorb iron, despite having adequate iron stores (1).
The excess iron is then deposited throughout the body, including within the joints and tissues, especially the heart, pancreas, and liver.
Over time, iron that’s deposited in the liver leads to liver cirrhosis.
Hemochromatosis is usually genetic and predominantly affects white males, which can also decrease men’s fertility.
The symptoms of hemochromatosis depend on the severity and the organs affected the most.
Common hemochromatosis symptoms include:
- joint pain
- fatigue and lethargy
- skin discoloration
- abdominal pain
- frequent illnesses
Women tend to develop symptoms later than men due to blood loss and therefore iron excretion due to menstruation or periods (1).
Diagnosis and treatment
To diagnosis hemochromatosis, your doctor will review your health history and any symptoms that you have been experiencing.
Your doctor may also perform various tests to confirm a diagnosis and rule out other conditions that have similar symptoms.
Tests for hemochromatosis can include:
- genetic testing
- a blood test to your iron levels and liver function
- a blood test to measure certain hormones
- imaging tests to view your heart and liver
- liver biopsy to check liver iron levels
- fasting blood sugar levels to test for diabetes
These tests can help your doctor identify any health problems from hemochromatosis and develop the best plan based on your goals for treatment.
Treatment usually involves regular phlebotomies or blood draws and the use of drugs called iron chelators, which remove extra iron from your body.
While following a hemochromatosis diet likely won’t eliminate your need for these medical treatments, it may help reduce the need for them while also reducing or preventing associated health problems.
Hemochromatosis foods to avoid
With hemochromatosis, you should limit foods rich in iron or nutrients that can enhance iron absorption as part of a meal.
You should also limit or avoid foods that can harm your liver or other organs that may have already been damaged from hemochromatosis.
Foods to limit or avoid include:
Heme iron-rich foods
Iron from foods is found in two forms — heme and nonheme.
Heme iron is found primarily in animal products whereas nonheme iron is found mostly in plant foods.
Heme iron has a much greater bioavailability than nonheme iron, meaning your body absorbs more iron from foods that contain heme iron compared with nonheme iron.
As such, you should limit your intake of foods rich in heme iron.
Foods highest in heme iron include:
- organ meats
Meat, fish, poultry also contain a type of protein — known as MFP factor for meat, fish, and poultry — that enhances the absorption of nonheme iron in the same meal (2).
While not a source of heme iron, breakfast cereals are commonly fortified with high levels of iron and therefore should be limited or avoided.
Certain dietary acids
Acids like vitamin C, citric, and tartaric acid enhance iron absorption by converting iron to its more absorbable form (2).
Additionally, these acids have been shown to inhibit compounds in food that enhance iron absorption like phytate and calcium.
Vitamin C and citric acid are found mostly in citrus fruits like lemons, limes, oranges, tangerines, grapefruits, and berries, whereas bananas and grapes contain tartaric acid.
You can eat these fruits alone as a snack but avoid consuming them with a meal.
Unlike sugars found naturally in fruits, vegetables, and dairy, added sugars are added to foods and beverages during the manufacturing process to enhance flavor, texture, color, or extend a product’s shelf life.
This can be especially harmful if your liver is already damaged from hemochromatosis.
Common sources of added sugars include desserts, candy, many breakfast cereals, some condiments, soda, energy drinks, and sports drinks.
In hemochromatosis, however, drinking any amount of alcohol should be avoided as doing so can accelerate both liver and pancreas damage.
Foods to lower iron levels
Emphasizing foods that are low in iron and adding foods that contain nutrients that decrease iron absorption with meals can help keep lower your iron and maintain normal levels.
Foods to lower iron levels include:
Whole grains like barley, brown rice, oatmeal, popcorn, and whole-grain bread, pasta, and crackers contain a compound called phytic acid (5).
Phytic acid — also referred to as polyphosphate or phytate — is the major storage form of phosphorus in plants.
The compound contains antioxidant properties but it also impairs the absorption of many minerals, including iron.
So while whole grains contain iron, the iron is poorly absorbed due to the phytic acid that’s present.
Legumes refer to beans, peas, and lentils.
They provide fiber, protein, B vitamins, and many minerals, including iron.
However, this iron is poorly absorbed by your body since legumes — like whole grains — contain phytic acid.
Avoid soaking legumes in water for long periods as this can reduce their phytic acid content (5).
Dairy products like milk, yogurt, and cottage cheese contain minimal to no iron and are good sources of calcium.
Calcium has been shown to inhibit iron absorption, but this inhibitory effect may weaken over time (6).
In either case, dairy products are also good sources of high-quality protein and can help you meet your protein needs in combination with legumes.
Tea and coffee
Tea and coffee contain plant-based compounds called polyphenols.
In addition to lowering your risk for several diseases, polyphenols inhibit iron absorption.
For example, one study found that drinking coffee with or just after a meal can reduce iron absorption by 40% (7).
Eggs are a nutritional powerhouse rich in B vitamins and vitamins A, D, E, and K.
They are also a great source of protein and the antioxidants lutein and zeaxanthin, which are great for eye health.
While whole eggs contain some iron, they also contain a protein that inhibits iron absorption called phosvitin (8).
Sample hemochromatosis diet menu
Here is a sample hemochromatosis diet menu that’s low in iron and high in foods that decrease iron absorption:
Breakfast: scrambled eggs, oatmeal, cubed muskmelon, and coffee
Snack: Greek yogurt and walnuts
Lunch: Mediterranean salad made with lettuce, chickpeas, cucumber, olives, red onion, crumbled feta, and extra-virgin olive oil
Snack: apple slices with peanut butter
Dinner: creamy mushroom cavatappi pasta
Snack: orange and banana slices
Use this sample meal plan as a guide for planning your diet according to your preferences, any dietary restrictions, and calorie needs.
Other tips for managing hemochromatosis
Here are a few tips to reduce your exposure to iron and potentially lower your iron levels:
Avoid iron cookware
Cooking using iron pots and pans can add significant amounts of iron to your food.
One study found that the amount of iron doubled in meat and vegetables and increased by 1.5 times in legumes when cooked in iron pots compared with other pots (9).
Stick with stainless steel, solid ceramic, or glass for your cookware material to avoid increasing the iron content of your food.
Pair certain foods and avoid pairing others
While it’s beneficial to limit your intake of iron-rich foods, it’s probably not worthwhile to completely avoid them.
Instead, limit the amount and frequency in which you eat iron-rich foods — especially heme iron.
Pairing foods that decrease iron absorption with iron-rich foods can also help.
For example, drink coffee or tea and include a whole grain like brown rice with a meal that contains meat or seafood.
At the same time, avoid combining foods rich in iron with foods that increase iron absorption like citrus fruits.
Avoid supplements with iron
If you regularly take dietary supplements — whether multivitamins or protein powders — always check the label to see if it contains iron.
A multivitamin may be useful in some instances but sometimes it’s best to supplement with individual nutrients that you may be lacking like vitamin D or fish oil.
The bottom line
Hemochromatosis, or iron overload, is a condition that occurs when your body stores too much iron from the food you eat.
Fortunately, by limiting foods rich in heme iron and including foods and beverages that decrease iron absorption with meals, you can lower your iron levels or potentially prevent them from becoming too high.
With hemochromatosis, you should also avoid alcohol and limit added sugars to reduce liver harm.
Finally, avoid cooking with iron cookware and always check any supplements that you take for iron.